Microsurgical Resection of Intramedullary Spinal Cord Metastases

NCT ID: NCT06042946

Last Updated: 2024-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-09-01

Study Completion Date

2025-07-31

Brief Summary

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The aim of the study is to establish a multi-center, retrospective database for patients with intramedullary spinal cord metastases (ISCM) and analyse the functional outcome in surgically treated ISCM patients.

The hypothesis is that the surgical treatment of selected ISCM patients does not lead to persistent morbidity and does not increase mortality, compared to patients that are treated non-operatively.

Secondary objectives are to assess pre- to postoperative neurological deficits, ambulatory status, and overall survival of surgically treated ISCM patients.

The investigators intend to include a control cohort of patients with ISCM from participating centers, who underwent non-surgical oncological treatment (radiotherapy with or without chemotherapy). This control cohort of patients will be used to match patients with and without surgical treatment.

Primary endpoint (analysed in surgically treated ISCM patients):

Functional outcome at 90 days after treatment initiation, measured by the modified McCormick Scale. This is a score for grading of neurological function in spinal cord conditions.

The McCormick scale ranges from Grade I (neurologically intact) to grade V (paraplegic or quadriplegic). The McCormick scale is suitable for our retrospective study because of its good reproducibility and comparability.

Secondary endpoints (analysed in surgically treated ISCM patients and analysed in matched patients with and without surgical treatment):

* Functional outcome by the McCormick scale and the modified Japanese Orthopaedic Association scale (mJOA) at 6 and 12 months. This is a score evaluating motor function of upper and lower extremities, sensory function of upper extremities and sphincter function / voidance. The mJOA ranges from 0 - 18 points, with higher score values representing better functional outcome. The minimum clinically important difference of the mJOA is 1-2 points, and scores lower than 14 indicate moderate myelopathy, scores lower than 11 indicate severe myelopathy.
* Ambulatory status and continence at 90 days, 6 \& 12 months (determined by mJOA subscores)
* Neurological outcome, measured by American Spinal Cord Injury Association (ASIA)
* Impairment Scale at 90 days, 6 and 12 months
* Rate \& type of complications at 90 days after treatment according to The Novel Therapy
* Disability-Neurology Grade (TDN grade)16
* Overall survival (in days)

Detailed Description

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Conditions

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Spinal Cord Metastasis Spinal Cord Tumor Malignant Intramedullary Functional Outcome Radiotherapy; Complications Spinal Cord Neoplasms

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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iscm_resection

-Adult patients admitted to one of the participating centres and treated for ISCM between 2017 and 2023 by resection of the ISCM with or without adjuvant radiotherapy

Microsurgical resection of ISCM

Intervention Type PROCEDURE

Microsurgical resection of ISCM defines the surgical removal of cancerous tumors that have spread to the spinal cord, using advanced microsurgical techniques and equipment like ultrasound, neuromonitoring, ultrasonic aspirator to prevent damage to the spinal cord.

iscm_radiotherapy

-Adult patients admitted to one of the participating centres and treated for ISCM between 2017 and 2023 by radiotherapy without resection of the ISCM

No interventions assigned to this group

Interventions

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Microsurgical resection of ISCM

Microsurgical resection of ISCM defines the surgical removal of cancerous tumors that have spread to the spinal cord, using advanced microsurgical techniques and equipment like ultrasound, neuromonitoring, ultrasonic aspirator to prevent damage to the spinal cord.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adult patients admitted to one of the participating centres and treated for ISCM
* Available documentation of admission and postoperative status

Exclusion Criteria

\- Patients under the age of 18
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Zürich

OTHER

Sponsor Role collaborator

Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role collaborator

University Hospital, Geneva

OTHER

Sponsor Role collaborator

Kantonsspital Aarau

OTHER

Sponsor Role collaborator

Kantonsspital Winterthur KSW

OTHER

Sponsor Role collaborator

Luzerner Kantonsspital

OTHER

Sponsor Role collaborator

Klinikum rechts der Isar Technische Universität München

UNKNOWN

Sponsor Role collaborator

University Hospital Muenster

OTHER

Sponsor Role collaborator

University of Toronto

OTHER

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role collaborator

Cantonal Hospital of St. Gallen

OTHER

Sponsor Role lead

Responsible Party

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Felix C. Stengel, MD

Junior Attending Neurosurgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Martin N. Stienen, PD, MD

Role: PRINCIPAL_INVESTIGATOR

Cantonal Hospital St. Gallen

Locations

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Cantonal Hospital St. Gallen, Neurosurgery

Sankt Gallen, , Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Martin N. Stienen, PD, MD

Role: CONTACT

+41 71 494 2183

Felix C. Stengel, MD

Role: CONTACT

+41 71 494 2184

Facility Contacts

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Martin N. Stienen, PD, MD

Role: primary

+41714942183

Felix C. Stengel, MD

Role: backup

+41714942184

Other Identifiers

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2023-00292

Identifier Type: -

Identifier Source: org_study_id

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